Jail and hospital officials remain divided about how best to handle an inmate accused of murder who is refusing to eat and is possibly suicidal. At issue is whether the hospital should force-feed someone who consciously chooses not to eat.

Fisherman’s Wharf merchant Hong Ri Wu was arrested at the scene of the Jan. 31, 2011, fatal shootings of two of his competitors, and has reportedly confessed to the killings. His attorney has expressed doubts about his mental competency to stand trial.

Wu, 57, has refused to eat for the past three weeks, Sheriff Michael Hennessey says. He is now being held at San Francisco General Hospital’s acute care facility, where hospital staff oversee his meals although he remains in sheriff’s custody.

On Wednesday, Hennessey tried to get a judge in Wu’s criminal case to order the health department to force-feed him, saying he feared for Wu’s life. But the judge declined to hear the matter immediately.

Hennessey insists his department has a mandate to provide for the safety of each inmate. But hospital officials have balked at force-feeding Wu, although spokeswoman Rachael Kagan declined to discuss Wu’s case specifically, citing patient privacy laws.

“As a hospital, we respect individual self-determination and include our patients in their health care decisions,” Kagan said in a statement. “When a patient is also in custody, that patient loses some rights, but not all of them.”

While there is some precedent for the force-feeding of inmates on hunger strike when there is an imminent risk to health, the issue has not been settled, noted UC Hastings associate professor of law Hadar Aviram.

“A medical patient in general has the right to make medical decisions about their own welfare, including the right to refuse medical treatment,” Aviram said. “That said, with inmates, there’s also the factor that the government has an interest in the proper functioning of the prison itself.”

Kagan said the Department of Public Health, just like the Sheriff’s Department, “wants the best outcome,” though “at times, the mandates of these departments can differ.” She called Wu’s case “a complex and heart-rending situation, with no easy answers,” and said the hospital would continue to provide “the best care possible.”

Sheriff’s Department spokeswoman Eileen Hirst said the two agencies are discussing the situation. “We are in communication with the Department of Public Health and considering our options,” Hirst said.